This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.

Monday, July 31, 2017

Weekly Australian Health IT Links – 31st July, 2017.

Here are a few I have come across the last week or so.

Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

Quite a lot happening this week with a new draft of the National Digital Health Strategy apparently being reviewed prior to release to Health Ministers in the next month or two.

Also some interesting announcements on other ADHA projects that will play out over the next little while as well as some other initiatives from the DOH.

Lots of further unhappiness also revealed regarding the NBN. This will be a pretty slow burn I reckon!

Patients requiring urgent medical care will benefit from a hospital emergency department pilot that gives clinicians fast, secure access to health information such as allergies and medicines that may not otherwise be available in hospital information systems.

The pilot will help drive the uptake of My Health Record, a digital system that enables healthcare providers to share secure health data and improves the safety and quality of patient care. To date, over 5 million people have a My Health Record and over 10,143 healthcare providers are connected.

“Where My Health Record is being utilised, we are seeing reductions in duplicated testing and lower hospital re-admission rates.

PROBLEMS with Queensland Health’s electronic medical record system are angering health workers, with fed-up senior doctors circulating a document slamming the technology and those in charge of it.

The document claims the integrated Electronic Medical Record (iEMR) puts patient safety at risk, is difficult to navigate and “unintuitive”.

The document, obtained by The Courier-Mail, likens the program to two of Queensland’s biggest health disasters, and claims the integrated Electronic Medical Record (iEMR) puts patient safety at risk, is difficult to navigate and “unintuitive”.

Youth mental health organisation Reach Out has launched a new mobile platform for young people to access help during tough times.

Source: AAP

Ashleigh Holder intended to die but ended up in hospital. Recovery has been a long journey.

Ms Holder, now an ambassador for youth mental health project Reach Out, said she didn't recognise she had a problem with anxiety back in 2011, and didn't even know what anxiety was.

"Anxiety impacted my ability to attend uni, go to my part-time job and spend time with family and friends," she said at the launch of the Reach Out mobile-first platform for youth mental health in Melbourne on Wednesday.

ReachOut Australia, the digital mental health service for young Australians and their parents, today launched a brand new platform providing a one-stop-shop for young people to connect to personalised support when they need it most.

ReachOut Australia CEO Jono Nicholas was joined by Federal Health Minister Greg Hunt and Telstra CEO Andrew Penn to unveil the mobile-first platform, which was co-designed with 174 young people.

Nicholas said the new ReachOut.com platform connects young people to free, anytime help – and focuses on prevention, self-help and early intervention.

Healthcare practitioners are a step closer to direct and secure communications with each other — without cumbersome fax machines.

New technology will enable health data to flow securely from one healthcare provider to another — irrespective of the software they are using, the organisation they work for or with whom they are communicating.

The technology is being developed by a clinical consortium following a tender process earlier this year. Under the auspices of the Australian Digital Health Agency, work is underway with HealthLink and Telstra — with a range of healthcare providers across a variety of locations engaged in current trials. The objective is to develop solutions that allow secure messaging between healthcare providers with different clinical information systems messaging vendors, in a way that can be scaled nationally.

But way forward unclear.

The Department of Health is confident it can find suppliers to replace its Medicare payments processing system before 2019.

But the agency has been told by industry that it should proceed with a "modular, flexible and staged" approach for the complex build of the new platform.

The proposed platform will replace 200 separate applications and 90 different databases that currently deliver 600 million payments worth $50 billion every year for Medicare, the pharmaceutical benefits scheme, veterans and aged care recipients.

Danuta Mendelson

Deakin University, Geelong, Australia - Deakin Law School

Gabrielle Wolf

Deakin Law School

Date Written: February 15, 2017

Abstract

The notion that a patient has the right to maintain the confidentiality of information disclosed in the course of a therapeutic relationship with a health practitioner has been entrenched in Western civilisation for thousands of years. For the first time, however, we have begun to witness an erosion of this entitlement, especially in Australia in recent years. The Australian Federal Parliament has created a system of co-linked national electronic health records that, by virtue of new technology, permits government bodies and myriad other third parties to access and disseminate individuals’ health information both lawfully and without authority, almost invariably in the absence of patients’ knowledge and consent. Commonwealth legislation has also facilitated the substitution of patients’ traditional right to confidentiality of their health information with a much broader and less clearly defined right to “personal privacy”. This chapter examines how these changes have led to a fundamental upheaval of longstanding understandings about the protection of information communicated and learned in the once secluded space of the consulting room.

The Australian Government will invest over $16 million to deliver the national roll-out of real time prescription monitoring for medicines to directly address the needless loss of life from misuse of these drugs.

The Turnbull Government will invest over $16 million to deliver the national roll-out of real time prescription monitoring for medicines to directly address the needless loss of life from misuse of these drugs.

The Real Time Prescription Monitoring system will provide an instant alert to pharmacists and doctors if patients received multiple supplies of prescription-only medicines.

The airplane had just taken off when one of the passengers lost consciousness. Eric Topol pulled his smartphone out of his pocket and immediately performed an electrocardiogram (EKG) on the passenger. He used the device to do an ultrasound scan of the man's heart and measured oxygen levels in his blood.

He was then able to give the all-clear and the plane could continue its journey. The man had lost consciousness merely due to a temporarily slowed heart rhythm.

Topol is a cardiologist in La Jolla, California, and it wasn't the first time he had encountered such a situation while flying. On one occasion, he used his mobile phone to determine that a passenger had suffered a heart attack and the plane had to land immediately.

For all its brilliance and its benefits, there is one thing machine medicine it can't do. It can't heal.It can diagnose and it can recommend treatment, but without a human soul it can't provide that intangible element that makes so many people feel better.

One day smart devices may be able to deliver much of the science of medicine but they will not be able to practice the art of medicine. How could they?

This art is expressed in the way doctors apply the science to patients. It is a nuanced, social and cultural process that deals with grey zones, employing intuition and compassion in the context of the patient's personal situation. In the art of medicine, it's often said that the doctor is the drug.

In Australia, a patient with cancer can track symptoms on their smartphone, then use the same phone to access medical records held on their GP's software. Later, their oncologist can use a different smartphone to calculate medication dosages.

And all three phone apps in this scenario – CancerAid, MediTracker and DoseMe – would be Australian inventions.

Future patients could use an Australian invention to diagnose respiratory diseases by merely breathing into their smartphone's microphone. ASX-listed company ResApp is researching this, supported by millions of dollars from investors.

Each year 230,000 people are admitted to hospital, and many more experience reduced quality of life, as a result of unintended side effects of their medicines. This comes at a cost to the system of more than $1.2 billion.

“The Agency and the Guild have a mutual interest in continuing to develop and deliver community pharmacy digital health capability that will lead to significant improvements in the quality and delivery of care provided to consumers,” said the DHA’s chief executive, Tim Kelsey.

The Pharmacy Guild has joined forces with the Australian Digital Health Agency to help build pharmacies’ digital health capabilities

Both the Agency and the Guild are strong advocates for the widespread adoption and use of the My Health Record system by community pharmacists to better the health of the public.

The Agency and the Guild have now entered into a collaborative partnership aimed at driving adoption and use of the My Health Record system by community pharmacies (supported by education and training) and maximising the medicines safety benefits.

Sarah-Jane Tasker

Jack Cosentino says he is an “impatient CEO” and the hectic pace he has set in his first five months as head of biotech Medibio — overhauling management, refreshing the board and sacking unwanted shareholders — backs that description.

The chief executive of the Australian-listed company says the aggressive pace will continue because he plans to deliver what will be the “largest mental health company on the planet”.

“I’ve done a lot of projects in healthcare but for my board and I this one is very personal — it’s mission driven,” he said.

In this technologically advanced age, we are able to draw knowledge from many interesting sources which were not previously available to us.

As they are increasingly integrated into healthcare, electronic and digital technologies enable the collection of increasing amounts of data. Data which we are able to translate into knowledge, to help us make more informed decisions, and to improve the quality of services.

Professor Atul Butte, of the Stanford School of Medicine reminded us that within “mounds of data is knowledge that could change the life of a patient, or change the world.”

Guest Bio: Andrew Tucker is the CEO of ITonCloud which helps businesses simplify and automate their IT systems by leveraging the cloud. Andrew has more than 20 years of experience as a successful business owner and passionate entrepreneur. His goal has always been to build and drive ventures to deliver unmatched service levels, customer value and trust.

Segment overview: In today’s Health Supplier Segment, we are joined by ITonCloud CEO Andrew Tucker here to talk about their cloud computing features. Andrew discusses how cloud computing is enabling the next wave of ehealth innovation. In addition, Andrew explains how cloud computing is driving ehealth innovation in the areas of mobility, data management, self-service for patients, operations and analytics of information for hospitals and private practices.

Anthony Klan

There could be almost two million “seriously dissatisfied” voting-age National Broadband Network customers in the lead-up to the next federal election, based on the internet network’s own figures.

NBN Co chief executive Bill Morrow tried this week to downplay mounting complaints, saying only 15 per cent of users were dissatisfied. However, given every household will be forced onto the network, the absolute numbers are huge and could cause major headaches for the federal government.

By June 2019, the NBN expects to have passed 10.6 million premises, with 6.7 million premises connected, of which about 90 per cent, or six million, will be homes, with the remainder businesses.

John Durie

NBN’s Bill Morrow is right when he places the NBN rollout into the context of it each week taking on 50,000 new customers and connecting 100,000 new homes, this would be a challenge for any company.

As outlined in today’s column, NBN is in the middle of a massive land grab, with all fixed-line customers up for grabs and the big telcos, in competition with 23 separate companies, are trying to resell the service directly and another 100 firms indirectly.

The aim of the game is to sign up customers by whatever means and explain to them later what they have done.

The Australian Communications and Media Authority expects formal standards for the first phase of 5G to be in place by mid- to late-2018, and deployments to start a year or two after that.

ACMA acting chairman Richard Bean told a telecommunications conference in Sydney last week that while everyone expected 5G to supplement, and probably replace existing standards like 4G over time, it was generally accepted that standardisation and harmonisation was still at the formative stage.

"(Everyone knows) that 5G is expected to deliver what is essentially a super-fast version of today’s mobile broadband networks, massive scale machine-to-machine communications necessary to support the Internet of Things, and ultra-reliable and low latency communications to support things like remote control of industrial or medical processes," Bean said.

Anthony Klan

None of the nation’s major telcos will guarantee that customers will experience super-fast internet under the National Broadband Network, or even that they will deliver the same speed packages being sold to them by the agency in charge of the $49 billion project­.

NBN Co, a wholesaler, sells a range of monthly connection packages to the telcos of 12 megabits per second, 25Mbps, and super-fast connections of 50Mbps and 100Mbps.

The telcos are also required to buy from NBN Co costly “bandwidth” to ensure those speeds can be achieved at peak times, such as after 5pm weekdays, when many people are using the internet at the same time.

Switching the national broadband network to using fibre-to-the-distribution-point technology is an interim solution; the correct solution, which will cost about the same, is to go full fibre.

This is the considered opinion of Mike Quigley, former chief executive of the NBN Co, who was asked by iTWire to offer a view on using FttDP in preference to the fibre-to-the-node technology that the majority of Australians will get under the NBN Co's current network rollout plan. Rod Tucker, Laureate Emeritus Professor at the University of Melbourne and a member of Labor's Expert Panel that advised on the NBN, was in agreement on this point.

A switch to FttDP has been repeatedly advocated by the head of the non-profit, Internet Australia, Laurie Patton.

Using fibre-to-the-distribution-point technology for the NBN instead of fibre-to-the-node will enable the Turnbull Government to save face and also provide a better network, a senior academic who was involved with the project at its inception says.

Rod Tucker, Laureate Emeritus Professor at the University of Melbourne and a member of Labor's Expert Panel that advised on the NBN, told iTWire in response to queries that if NBN Co made a switch from FttN to FttP, then it would reflect badly on Communications Minister Mitch Fifield.

"After all the recent criticism levelled at FttP by Fifield, how could NBN Co be expected to admit that he is wrong and that FttP is now affordable?" he asked.

Internet Australia executive director Laurie Patton has repeated his call for the government and Opposition to come together and commit to using fibre-to-the-distribution-point for as much of the possible of the remainder of the NBN rollout.

In a statement issued on Sunday, Patton said the non-profit believed that NBN Co, the company rolling out the broadband network, must abandon its "flawed policy" of using the copper-based fibre-to-the-node and move to FttDP (what NBN Co calls FttC or fibre-to-the-curb). Patton said the move "is essential for Australia's economic and social development".

Patton has been a constant critic of the multi-technology mix option - which includes a small number of FttP connections, FttN, FttDP, HFC, wireless and satellite - adopted by the Coalition Government for the rollout, after it came to power in 2013. The Labor Party, which began the rollout in 2009, had a policy of fibre-to-the-premises for 93% of residences, with the remainder to be served by wireless and satellite.